ArticlePublic health nutrition2016
Gender inequalities in excess adiposity and anaemia combine in a large double burden of malnutrition gap detrimental to women in an urban area in North Africa.
Article in Public health nutrition, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Prevalence Trends and Associated Factors of the Double Burden of Malnutrition Among Rwandan Women of Childbearing Age: Evidence From Demographic Health Surveys, 2010-2020.Public health challenges · 2026Article
- Malnutrition Among Children Under Five in Djibouti: A Composite Index of Anthropometric Failure Analysis from the 2023 Multisectoral Survey.Nutrients · 2026Article
- Sexual dimorphism in selenium deficiency is associated with metabolic syndrome and prevalence of heart disease.Cardiovascular diabetology · 2023Article
- Malnutrition and gender disparities in the Eastern Mediterranean Region: The need for action.Frontiers in nutrition · 2023Article
- Sex Differences at Early Old Stage in Glycolipid Metabolism and Fatty Liver in Offspring Prenatally Exposed to Chinese Great Famine.Frontiers in nutrition · 2022Article
- Farm production diversity and women's dietary diversity: Evidence from central Tunisia.PloS one · 2022Article
- Article
- Unbalanced intakes of sodium and potassium among Tunisian adults: A cross-sectional study.Food science & nutrition · 2021Article
- Prevalence of Hypertension and Adherence to Dietary Approaches to Stop Hypertension Diet Score in Childbearing Age Tunisian Women: A Cross-Sectional Study.BioMed research international · 2021Article
- Association between central obesity indices and iron status indicators among Qatari adults.PloS one · 2021Article
- The Double Burden of Malnutrition at the Individual Level Among Adults: A Nationwide Survey in the Philippines.Frontiers in nutrition · 2021Article
- The double burden of malnutrition: aetiological pathways and consequences for health.Lancet (London, England) · 2020Review
- Gender inequalities in diet quality and their socioeconomic patterning in a nutrition transition context in the Middle East and North Africa: a cross-sectional study in Tunisia.Nutrition journal · 2019Article
- Intra-household double burden of malnutrition in a North African nutrition transition context: magnitude and associated factors of child anaemia with mother excess adiposity.Public health nutrition · 2019Article
- Association of adiposity with hemoglobin levels in patients with chronic kidney disease not on dialysis.Clinical and experimental nephrology · 2018Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe nutrition transition has exacerbated the gender gap in health in the Middle East and North Africa region as the increase in excess adiposity has been much higher among women than men. This is not exclusive of the persistence of anaemia, generally also more prevalent among women. We assessed the magnitude and sociodemographic factors associated with gender inequality vis-à-vis the double burden of excess adiposity and anaemia.
designCross-sectional study, stratified two-stage cluster sample. BMI (=weight/height2) ≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity. Anaemia was defined as Hb <120 g/l for women, <130 g/l for men. Gender inequalities vis-à-vis the within-subject coexistence of excess adiposity and anaemia were assessed by women v. men relative prevalence ratios (RPR). Their variation with sociodemographic characteristics used models including gender × covariate interactions.
settingGreater Tunis area in 2009-2010. SUBJECTS: Adults aged 20-49 years (women, n 1689; men, n 930).
resultsGender inequalities in excess adiposity were high (e.g. overweight: women 64·9 % v. men 48·4 %; RPR=2·1; 95 % CI 1·6, 2·7) and much higher for anaemia (women 38·0 % v. men 7·2 %; RPR=8·2; 95 % CI 5·5, 12·4). They were striking for overweight and anaemia (women 24·1 % v. men 3·4 %; RPR=16·2; 95 % CI 10·3, 25·4). Gender inequalities in overweight adjusted for covariates increased with age but decreased with professional activity and household wealth score; gender inequality in anaemia or overweight and anaemia was more uniformly distributed.
conclusionsWomen were much more at risk than men, from both over- and undernutrition perspectives. Both the underlying gender-related and sex-linked biological determinants of this remarkable double burden of malnutrition inequality must be addressed to promote gender equity in health.
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